Occlusal adjustment for treating and preventing temporomandibular joint disorders

Abstract

To assess the effectiveness of occlusal adjustment (OA) for treating temporomandibular disorders (TMD) in adults and preventing TMD. The Cochrane Controlled Trials Register, MEDLINE and EMBASE were comprehensively searched using the Cochrane methods. Reports and review articles were retrieved. Unpublished reports or abstracts were considered from the SIGLE database. All randomized or quasi-randomized controlled trials comparing OA with placebo, reassurance or no treatment in adults with TMD. The outcomes were global measures of symptoms, pain, headache and limitation of movement. Data collection and analysis followed the Cochrane Oral Health Group's statistical guidelines. Results showed no difference between OA and control group in symptom-based outcomes for treatment or incidence of symptoms for prevention. There is no evidence that OA treats or prevents TMD. OA cannot be recommended for the management or prevention of TMD. Future trials should use standardized diagnostic criteria and outcome measures when evaluating TMD.

Treatment of temporomandibular disorders – knowledge, attitudes and clinical experience among general practising dentists in Sweden

“…[9] Occlusal adjustment has been questioned as a TMD therapy for many years. [19,20] To perform reversible TMD treatments is the predominant treatment concept in Scandinavia. [2] These two facts might have influenced and reduced the frequency of occlusal adjustment performed and thereby also the selfreported frequency of good clinical routine and confidence for this treatment.…”

Risk management in clinical practice. Part 8. Temporomandibular disorders

“…There is also insufficient evidence to support the generalised preventive influence of occlusal adjustment or orthodontic correction of malocclusion on TMD development. 36,37 Controlled studies of occlusal factors and TMD show either no relationship or at best only a weak correlation between specific variables and TMD. [38][39][40] When considering those authors who argue that specific occlusal factors might make some biological contribution to a TMD and thus should not be ignored, 41,42 it should be remembered that a biological system will frequently adapt to various morphologic features until stability is achieved.…”

Orthodontics is temporomandibular disorder–neutral

“…Such an approach is actually not supported, and systematic reviews of the literature provide evidence-based recommendations that there is a lack of causal relationship between TMD and occlusion; they also offer evidence that irreversible occlusal treatments are not more useful than conservative treatment alone to either manage or prevent TMD. [11][12][13][14] The literature [15][16][17] on the effects of orthodontic treatment supports the neutral effects on the temporomandibular joint (TMJ). In particular, a recent systematic review 16 concludes that there are insufficient research data on the relationship between active orthodontic intervention and TMD on which to base our clinical practice.…”